The rapid development of telecommunications technology has brought it to a point where it has become a cost-effective way to deliver medical care (telemedicine), especially to rural underserved areas. The critical need for the U.S. to explore new ways for both improving the delivery of care to all people, and to decrease the cost, mandates that this technology be actively explored. The Second Mayo Telemedicine Symposium will examine the uses of a full array of two-way telecommunications systems for improving access to modern medical care in the U.S. Both low-tech and high-tech options will be explored. This symposium, April 6-9, 1995, will bring together a wide range of individuals from tertiary medical care facilities, providers of care to underserved rural and urban populations, telecommunications and technology industries, and health policy analysis to approach this issue. The symposium will be held in conjunction with the Second International Conference on the Medical Aspects of Telemedicine, which means an exceptionally comprehensive U.S. and international audience will be in attendance. A consensus conference, held as part of the First Mayo Telemedicine Symposium, constructed a detailed set of criteria to guide the effective development of telemedicine. The goal of the Second Mayo Symposium will be to evaluate progress in the past 18 months against those criteria, and continue exploration of creative new ways in which telemedicine can be used to improve cost-effective delivery of health care in the U.S. Emphasis will be placed on reliability as a medical care delivery system, acceptability to patients and health care providers, and cost comparisons of different systems - today and in the 21st century. A mixture of plenary presentations, hands-on demonstration of telemedicine, and workshops will give the audience a balance between hearing about ongoing and emerging applications, and active participation in outcome-oriented education. As with the first conference, the Mayo satellite video communications system will be used to simultaneously convene the symposium at Mayo Clinics in Rochester, MN, Scottsdale, AZ and Jacksonville, FL. Attention will be focused on progress in overcoming jurisdictional barriers, and addressing research questions to allow for maximum effective us of telemedicine. Funding from the Agency for Health Care Policy and Research will permit attendance by providers of healthcare to rural and urban underserved populations, to expand their input into research on how to best use telemedicine to deliver healthcare in their communities.